Effectiveness of Intra-Oral Versus Trans-Buccal Techniques in Reducing PostOperative Complications (Infection and Swelling) In Mandibular Angle Fractures

Objectives: To compare the effectiveness of intra-oral and trans-buccal surgical approaches in reducing post-operative complications and improving clinical outcomes in patients with mandibular angle fractures. Study Design & Setting: This prospective comparative observational study was conducted at the Department of Oral and Maxillofacial Surgery, Institute of Dentistry, CMH Lahore Medical College, from May 2025 to October 2025. Methodology: A total of 92 patients with isolated mandibular angle fractures were enrolled, with 46 treated using the intraoral approach (Group A) and 46 using the trans-buccal approach (Group B). Data were collected on operative time, intraoperative blood loss, infection, swelling, paraesthesia, and fixation stability. Outcomes were categorized as effective, partially effective, or ineffective. Statistical analysis included chi-square/Fisher’s exact test for categorical variables, independent t-test for continuous variables, logistic regression for predictors of effectiveness, and relative risk analysis for complications. Results: The mean duration of surgery (75.3 ± 12.4 vs 68.7 ± 11.5 min, p = 0.01) and intra-operative bleeding (85.6 ± 15.2 vs 78.4 ± 12.8 mL, p = 0.03) were significantly higher in the intra-oral group. Infection (21.7% vs 10.9%, p = 0.17) and paraesthesia (8.7% vs 4.3%, p = 0.40) were more frequent in the intra-oral group, although not statistically significant. Overall success rate was significantly higher in the trans-buccal group (93.5% vs 82.6%, p = 0.04). Logistic regression confirmed the trans-buccal approach as an independent predictor of effective outcome (Adjusted OR = 2.60, 95% CI: 1.02– 6.54, p = 0.045). Relative risk analysis showed higher risks of infection (RR = 2.00), severe swelling (RR = 1.80), and paraesthesia (RR = 2.00) in the intra-oral group, though without statistical significance. Conclusion: The trans-buccal approach offers significant advantages in terms of shorter operative time, reduced blood loss, and higher overall effectiveness compared with the intra-oral approach. Although infection and complication risks were higher in the intra-oral group, differences were not statistically significant. These findings support the trans-buccal approach as a more reliable surgical option for mandibular angle fractures